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General NPI Number Information
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NPI Number | 1689770174
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Entity Type | Organization
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Legal Business Name | SHELBY EAR NOSE AND THROAT
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1228 1ST ST N
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City | ALABASTER
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State | AL
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Zip | 35007-8702
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Country | US
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Telephone | 205-621-8900
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Fax | 205-621-7169
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Provider Business Mailing Address
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Address Line | 1228 1ST ST N STE 301
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City | ALABASTER
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State | AL
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Zip | 35007-8702
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Country | US
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Telephone | 205-621-8900
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Fax | 205-621-7169
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Authorized Official
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Title or Position | OFFICE ADMINSTRATOR
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Name | MELANIE GOGGINS
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Credential |
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Telephone | 205-621-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20146
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License Number State | AL
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